ECOG randomized patients with advanced NSCLC to 1 of 4 new 3 of the 4 regimens used in ECOG docetaxel/cisplatin, paclitaxel/cisplatin. In the ECOG trial, the only direct comparison of similar regimens, response rates and survival times were similar between patients treated with cisplatin. ECOG was chosen as a plenary session presentation because it is an important trial that reflects the state of care in of metastatic NSCLC—the.
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Grade 3 or 4 alopecia was more common with PCb. Also, with the growing acceptance and momentum favoring treatment of patients with metastatic NSCLC, investigators are placing patients on trial that are more reflective of the general population of lung evog patients.
Lung Cancer Highlights
In this window In a new window. There was an imbalance by sex with more men being in the CP-alone arm. Stronger evidence on the latter two points ecov expected from new clinical research specifically focused on PS2 patients affected by NSCLC. Do all patients with advanced non-small-cell lung cancer benefit from cisplatin-based combination therapy?
Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer.
Disease-free survival was prolonged by 1. Antiemetic prophylaxis was administered to all patients, and patients receiving cisplatin received hydration. First, biological therapies hold the promise of being more selective and less toxic for normal tissues, both in terms of haematological and non-haematological adverse effects. Comparison of survival and quality of life in advanced non-small-cell lung cancer patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: Lung Cancer ; Underrepresentation of patients 65 years of age or older in cancer-treatment trials.
It is not likely that a five-week prolongation of disease-free survival is significant enough to change the standard of practice, particularly when there was no change in overall survival and toxicity was present.
Taxane-Platinum Combinations in Advanced Non-Small Cell Lung Cancer: A Review
Jpn J Cancer Res. The phase III studies reviewed here demonstrate a benefit of the DC doublet in terms of all these end points. Analysis and interpretation of treatment effects in subgroups of patients in randomized clinical trials. Because of its low aqueous solubility, the vehicle for paclitaxel is a purified polyoxyethylated castor oil, which has been implicated in paclitaxel toxicity [ 89 ] and in the nonlinear pharmacokinetics of paclitaxel [ 10 — 12 ].
In the meta-analysis published inalthough overall results were limited by statistical heterogeneity and evident outcome differences for the different chemotherapy categories, a significant benefit was demonstrated for cisplatin-based trials, and a sub-group analysis confirmed this benefit for both good and poorer PS patients [ 12 ]. Clearly we have reached our limit in developing doublet platinum-based combinations for advanced NSCLC. Taking into account the superiority shown by the carboplatin—paclitaxel combination compared to paclitaxel alone, even in PS2 patients, in one clinical trial [ 37 ], carboplatin-based doublets may also be considered as an alternative option in a selected sub-group of patients.
From the Cover Conflict of Interest: Table 5 shows the most important research priorities for PS2 patients. The results of several large phase III studies are reviewed below. Overall survival was the primary endpoint of this study.
The choice of the drug should be based on the toxicity profile of each agent and type of co-morbid conditions. Cremophor EL causes pseudo- non-linear pharmacokinetics of wcog in patients.
Alert me to eco issues of The Oncologist. Paclitaxel plus carboplatin versus gemcitabine plus paclitaxel in advanced non-small-cell lung cancer: N Engl J Med. After four cycles of treatment, the instrument favored GC versus VC for peripheral neuropathy and VC versus PCb for pain, peripheral neuropathy, and alopecia [ 16 ]. Commentary This study is one of the first to randomly compare a novel agent with chemotherapy versus chemotherapy alone. J Eckg Oncol ; Triplet combinations will be pursued, as they should, but they too are unlikely 15944 produce clinically meaningful advances for patients with lung cancer.
Italian Lung Cancer Project. Median age of patients enrolled in randomised clinical trials is often significantly lower than that observed in clinical practice [ 1617 ], and eligibility criteria request good renal, hepatic and cardiac function, as well as absence of other significant co-morbidities.
The clinical evaluation of chemotherapeutic agents in cancer. Docetaxel Taxotere shows survival and quality-of-life benefits in the second-line ecpg of non-small cell lung cancer: Accepted June 29, Various chemotherapy regimens have been evaluated in an attempt to improve on the outcomes achieved with BSC. Alert me to new issues of The Oncologist. Email alerts New issue alert. Although a substantial improvement in overall survival should obviously be the ideal aim of clinical research, considering the very poor prognosis of PS2 patients irrespective of the treatment administered, patient-related end points other than overall survival symptom relief, clinical benefit, health-related QoL should play a central role in the planning, conducting and analysing of trials dedicated to PS2 patients.
The principle endpoint of the ECOG study will be overall survival, and there will be no cross over between the two arms of the study.